Angioedema: a 24-hour photo diary by a patient posted on Flickr


Angioedema: a 24-hour photo diary by a patient posted on Flickr

The patient took pictures of herself and uploaded them to the photo sharing website Flickr under a Creative Commons license. She had the impression her symptoms were due to urticaria but since the process affects the subcutaneous tissues (note the upper lip edema), the more likely diagnosis is angioedema and urticaria.

Dr Heinrich Quincke first described the clinical picture of angioedema in 1882, hence the eponym Quincke's edema. Sir William Osler remarked in 1888 that some cases may have a hereditary basis; he coined the term hereditary angio-neurotic edema.


C1 protein, showing subunits C1r, C1s, and the C1q tails. Image source: Wikipedia. Patients with acquired angioedema have low C1q levels AND low C4/C2 levels. In contrast, in hereditary angioedema (HAE) the C1q level is normal.


Classical and alternative complement pathways. Image source: Wikipedia.

Read more about Angioedema at AllergyCases.org.

Link via AllergyNotes.

13 comments:

  1. why does she wear lipstick in this situation?

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  2. Urticaria is a problem I've faced multiple times since having a pituitary adenoma removed. It goes along with adrenal insufficiency (AI) for me. I'm wondering about the comment "cortisone stains irreversibly the skin when exposed to the sun. Viva la summer!"

    That (and I'm not a doctor) sounds like high ACTH to me with low cortisol. AI?

    Just my two cents worth.

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  3. As an angioedema person myself, I would guess she's not wearing lipstick...your lips get pretty coloured when they are swelling. Also, I also have urticaria along with the angioedema - sometimes they seem to go together.

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  4. I keep having that same problem with my angioedema. I have had seven attacks this year alone, on in my lungs....I just want them to stop.

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  5. Jennifer,

    Angioedema does not usually affect the lungs. Please see an allergist.

    ReplyDelete
  6. The words you used were "does not usually" and I see an allergist and angioedema specialist for the past ten years.
    And I have had one episode where it affected my lungs...most the time just my mouth and throat.

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  7. Angioedema does not affect the lungs - it's a skin/mucosal condition. Anaphylaxis does. This is the difference.

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  8. My case of angioedema was much worse when I was living in a basement with mold present. Attacks have stopped since moving out except for a few very mild instances. I am still taking allegra, though the medication itself has never prevented an attack. I have since found out that my sister has also had an ocassional bout with the same condition. So is it purely allergy related or does heredity also play a role in my case?

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  9. mainerlbean,

    You need to see an allergist who will check your C1 inhibitor level and C4 and will be able to answer the question if your condition is hereditary or not. You need a blood test, history is not enough.

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  10. Angioedema can effect all mucous membranes and even connective tissue:
    I get swelling in all my joints, airways swelling, intestinal swelling facial, throat -you name it. I am under care of professor and Senior Clinical fellow in Immunology and I assume they know what they are talking about.

    Each individual is different and illness symptoms can therefore manifest differently: let's be respectful of that in our replies-no one needs "their story" of their illness disputed-surely we are here to share and support.

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  11. My daughter has just been diagnosed with this but She has had trouble all her life on an off. At the moment it is getting quite servere and up to 3 times per week lasting a day an a ahlf at a time so very up setting . Is there any cure? We are waiting for an appointment to see an Immune specialists. It has effected her air ways twice before as well as the severe lip and eye swelling.

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  12. Would it be a good idea to see and immune specialist? I see an ENT who prescribed an Epi-pen when it affects my throat and he did do blood work for C1 C4 which were normal. What would an immune specialist do?

    ReplyDelete

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